The present invention relates to electrocardiographic (ECG) monitoring systems and, more specifically, to ECG monitoring systems that allow simultaneous pacing during electrogram visualization using epicardial pacing leads.
Telemetry monitoring allows medical professionals to monitor electrical activity of the heart in real time and for extended periods of time. Telemetry monitoring is often utilized after cardiac surgery, when patients are most at risk for arrhythmias. Abnormally slow or fast heart rhythms can cause increased morbidity and mortality in the patient. Atrial fibrillation is a common arrhythmia encountered postoperatively, although ventricular arrhythmias and conduction disturbances can also occur.
Atrial arrhythmias can be difficult for medical professionals to differentiate when monitoring surface ECG leads.
Due to this risk of postoperative arrhythmias, many patients have temporary epicardial pacing wires placed on the outside of their heart epicardium (outer layer of heart muscle) to permit pacing of the heart (via an artificial temporary pacemaker). The proximal ends of the epicardial pacing wires are normally wrapped and taped to the outer chest wall until needed for arrhythmia treatment.
Normally, cardiac rhythms are obtained from surface ECG electrodes placed on the patient's chest and viewed on bedside monitors. However, since atrial signals are not easily visualized using surface ECG electrodes, if the medical professional detects an irregularity, an ECG technician may be called to connect the epicardial pacing wires to an ECG monitor so that a medical professional can interpret the ECG signals with more accuracy (since the proximity of the recording wires to the atrial impulses greatly enhances atrial waveforms). If an arrhythmia is detected and the medical professional wishes to pace the heart, the epicardial pacing wires are detached from the ECG monitor and reconnected to a temporary pacemaker for pacing.
The process of connecting the epicardial pacing wires is time-consuming, and may need to be repeated for successive rounds of visualization and pacing. This also carries with it a risk of misconnection of three sets of wires from the ECG monitor, the pacemaker, and the epicardial connections.